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1528783172
SHANA CLARK
WATERTOWN, NY
NPI
1528783172
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 329830)
Enumeration Date
2022-10-06
Last Update Date
2022-10-06
Business Address
SHANA CLARK LPN
211 JB WISE PL
WATERTOWN, NY 13601-2507
Phone number: 315-782-7445
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Mailing Address
SHANA CLARK LPN
PO BOX 6550
WATERTOWN, NY 13601-6550
Phone number: 315-782-7445
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